Context: The use of thiopurine drugs such as azathioprine and 6-mercaptopurine has become quite common in the treatment of inflammatory bowel disease, transplantation and acute leukemias. Despite their effectiveness, these drugs are capable of causing drug-induced toxicity with the risk of death by myelosuppression. It is now known that these complications occur because of genetic polymorphisms of the thiopurinemethyltransferase (TPMT) enzyme, responsible for its metabolism.
Objective: To assess the prevalence of thiopurine methyltransferase polymorphisms in the population of Joinville, SC, Brazil.
Methods: We analyzed the frequency of four main allelic variants of the TPMT gene in 199 blood donors from Joinville, from February to April 2010.
Results: The normal allele ("wild-type") was found in 93.9% of subjects studied. TPMT variants were detected in 12 subjects (6.03%).
Conclusions: From this study, it was estimated at 6% the risk of toxicity by the administration of azathioprine and 6-mercaptopurine to patients in Joinville.
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http://dx.doi.org/10.1590/s0004-28032012000200007 | DOI Listing |
J Med Case Rep
January 2025
Gastroenterology Unit, Enugu State University of Science and Technology, Parklane, Enugu, Nigeria.
Background: Autoimmune hepatitis is a chronic liver disease marked by immune-mediated inflammation, necrosis, and the potential to progress to cirrhosis if not treated. This case report presents a rare and atypical presentation of autoimmune hepatitis in a Nigerian adolescent girl, highlighting diagnostic challenges in resource-limited settings. The case is unique owing to the absence of jaundice, a common symptom of liver dysfunction, and features such as delayed menarche and bilateral leg swelling.
View Article and Find Full Text PDFJ Pak Med Assoc
January 2025
Department of Rheumatology, Shalamar Institute of Health Sciences, Lahore, Pakistan.
Primary Sjogren's syndrome (pSS) typically presents with Sicca symptoms xerostomia and xeropthalmia. This study highlights atypical presentations of Primary Sjogren's syndrome posing diagnostic and therapeutic challenges. Four female patients (median age 30 years, IQR = 15.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
Department of Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney 2139, New South Wales, Australia.
Background: Ulcerative colitis (UC) is a chronic inflammatory condition requiring continuous treatment and monitoring. There is limited pharmacokinetic data on vedolizumab during maintenance therapy and the effect of thiopurines on vedolizumab trough concentrations is unknown.
Aim: To investigate the exposure-response relationship of vedolizumab and the impact of thiopurine withdrawal in UC patients who have achieved sustained clinical and endoscopic remission during maintenance therapy.
Metabolites
December 2024
Department of Medicinal Chemistry, University of Washington, Seattle, WA 98195, USA.
Background: Thiopurine methyltransferase (TPMT) plays a crucial role in the detoxification of thiopurine drugs, including the antimetabolites azathioprine and 6-mercaptopurine (6-MP) used to treat autoimmune diseases and various cancers. These drugs interfere with DNA synthesis by inhibiting the production of purine-containing nucleotides, leading to the death of rapidly dividing cells. TPMT inactivates thiopurine drugs by methylating at the thiol group.
View Article and Find Full Text PDFPan Afr Med J
December 2024
Laboratoire de Biologie et Santé, Faculté des Sciences, Université Ibn-Tofail, Kenitra, Maroc.
Introduction: the purpose of our study is to evaluate the efficacy of azathioprine as first-line treatment in patients with relapsing-remitting multiple sclerosis (RRMS) or progressive multiple sclerosis (PMS), who were supposed to be treated with beta-interferons but, due to limited resources, received azathioprine instead.
Method: among the 31 patients, 17 had relapsing-remitting MS (RRMS), 11 had primary progressive MS (PPMS), and 3 had secondary progressive MS (SPMS). Patients received azathioprine orally at a dose of 3 mg/kg/day over 2 years.
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